Risk factors analysis for spinal deformity following resection of intradural spinal cord tumors from posterior approach: systematic review and meta-analysis.

PURPOSE

The presented study aimed to identify risk factors for spinal deformity (SD) following resection of intradural spinal cord tumors via posterior approach.

METHODS

Articles of interest were found in accordance with PRISMA guidelines utilizing the following databases: PubMed, Web of Science, and Scopus. Keywords such as "laminoplasty","laminotomy","laminectomy","tumor","resection","spinal deformity","kyphosis","intradural","intramedullary","extramedullary" were applied. Odds ratios (OR) were estimated for dichotomous variables.

RESULTS

From eleven retrospective studies comprising 715 patients, with mean age 17.1 years, 183 developed postoperative SD. Younger age (25 years or below; OR 4.03; p < 0.0001;13 years and below; OR 3.72; p = 0.003) was associated with an elevated risk of SD development. Patients in the age group of > 5 and ≤ 21 years old showed increased risk in the non-fusion subgroup only (OR 9.36; p = 0.02). Preoperative SD was a strong predictor of postoperative SD (OR 12.19; p = 0.0007), particularly accentuated in the non-fusion subgroup (OR 22.14; p < 0.00001). In the non-fusion subgroup, intramedullary tumor location emerged as a significant risk factor for SD (OR 3.67; p = 0.04). Involvement of the thoracolumbar junction increased the risk of postoperative SD (OR 3.11; p = 0.04). In the fusion subgroup, surgery encompassing at least 3 spinal levels elevated the risk of SD (OR 9.18; p = 0.02).

CONCLUSION

Risk factors for postoperative spinal deformity include younger age, preoperative SD, thoracolumbar junction involvement, extensive decompression, and intramedullary tumor location. These findings provide insights for clinicians in strategizing optimal surgical strategies for patients with high risk of SD development. PROSPERO registration no.: CRD42024517309 ( https://www.crd.york.ac.uk/PROSPERO/ ).